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Reaching New Levels

Pregnancy and Diabetes Blog

I had read and researched and absorbed all things pregnancy-related and diabetes before I got pregnant. I read over and over about the dreaded first trimester lows that seem to stick with you no matter what. I had also read about the haunting insulin resistance that begins in the second trimester. I knew that by the end of my pregnancy that I would be taking roughly three times the amount of insulin that I normally do. I knew all these things, but I didn't realize how much they would affect me, emotionally. I'm taking more insulin, basal and bolus, than I've ever taken in my life, and I'm just over halfway through my pregnancy.

It all started when I noticed that my fasting numbers were beginning to climb. At the beginning of my pregnancy, I would see numbers well below 90 mg/dL and closer to the 60s and 70s. Then I started seeing numbers in the 90s and low 100s, which are still perfectly acceptable but I knew that meant my body was starting to need more insulin. Then I noticed that certain foods that I had down to a science with my bolus ratios were starting to give me trouble. I would need an extra 0.5 units of correction two hours post-prandial. Everything was lining up to be this perfect storm of increased insulin needs and frustration over not knowing my own body anymore.

On top of all this, I had a kinked site the other day that left me in tears and overall feeling of "I can't do this anymore!" I've had maybe three bad sites in the four years that I've been on the pump. The one big way I can notice that I have a bad site is if I need to constantly correct a stubborn high. Normally, it takes less than an hour for insulin to do its thing and begin bringing me down. But the other day I had had a big lunch thanks to a retirement in my office, and I soared above 250 mg/dL and stayed there for three hours! I was testing every 30 minutes and giving myself unit after unit of correction, but nothing. Finally, I ended up leaving work early to change my site and give myself a formal injection (something I haven't done in years). I ignored the "Active insulin" on my pump and corrected for the number in whole. Thirty minutes later I was coming down and eventually landed at 98 mg/dL an hour later. But it wasn't after a few choice words and a "Please, please just go down!" talk with my pump.

After that fiasco with a kinked site, I adjusted my basal rates and my bolus ratios to level me out to some more reasonable numbers. Right now, my total basal rates sum up to 19.5 units/day and my current bolus ratio is 1 unit:6.5 grams of carbs, which puts me at almost double my pre-pregnancy rate of 1:12. I told myself in the beginning that I wouldn't worry about the amount of insulin I was taking as long as it meant my baby was safe and seeing good numbers from me. But I must admit that it's hitting me more, emotionally, than I had anticipated. It's fairly similar to my weight gain that is rocking at a whopping 15 lbs so far, I don't care what the number is as long as I'm healthy and so is she.

Every pregnancy is different and everybody's numbers will be different. I didn't expect to have a textbook pregnancy, whatever that is, but I guess I wasn't ready for the emotional toll that taking this amount of insulin would have on me. I'm beginning to avoid carbs, out of fear more than out of dietary restriction. Even at this early stage in parenting, I want only the best for my daughter--including my own blood sugar values.